Individual provider Active NPI

Takara N Harris, TRICHOLOGIST

  • Customized Equipment (DME)
  • Richmond Hill, GA
National Provider Identifier
1598225534
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Practice address
3766 US Highway 17 Ste 102
Richmond Hill, GA 31324-8872
Phone
(921) 312-7272
NPI assigned
Mar 25, 2019
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X NU Primary
Specialist 174400000X CO124945 GA
Health & Wellness Coach 171400000X NU

Addresses

Primary practice location

3766 US Highway 17 Ste 102
Richmond Hill, GA 31324-8872

Mailing address

172 Saint Ives Dr
Savannah, GA 31419-8917
Phone (912) 312-7272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CO124945GAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Restored Crown Hair Restoration Clinic LLC Specialist CurrentSince Feb 7, 2021 Accepting new patients

Locations

3766 US Highway 17
Ste 102
Richmond Hill, GA 31324
Phone (912) 312-7272

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1598225534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 SAINT IVES DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314198917",
            "telephone_number": "912-312-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3766 US HIGHWAY 17 STE 102",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313248872",
            "telephone_number": "921-312-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "TAKARA",
        "middle_name": "N",
        "credential": "TRICHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "CO124945",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.